Chevron Corporation                            Critique

The Healthquest fitness centers, smoking cessation programs and alcohol reduction programs have resulted in medical costs remaining virtually flat between 1991 and 1997 for an overall increase of less than one percent.  Occupational incident rates decreased by 50% and occupational incident rates with lost time decreased by 60%.  A rigorous, quasi-experimental study conducted on the Healthquest fitness centers by an outside objective evaluator demonstrated cost-savings through reduction in medical expenditures and lost workdays.  Alcohol use and smoking have steadily declined since 1991.

SPECIFIC COMMENTS INCLUDED:

The program has HRA data on two-thirds of the population.  High participation overall in the program occurs in spite of a decentralized model.   Chevron is considering an overall company health metric.  There are nine fitness centers which allow participation on company time.   The program has been developed by consensus.  The program is based on stages of change coupled with organizational change theories and focuses on both individual and systems level changes.  Results accepted for publication in The Journal of Occupational and Environmental Medicine.  Dose response effects have been established with the fitness facility.  The program has strong leadership.  The emphasis on occupational safety is a plus.

RESERVATIONS INCLUDED:

The bonus tied to safety performance raises questions about integrity of accident reporting.  How was the HRA data used?  Secular effects over the 1991-1997 period cannot be entirely ruled out.  It is unclear how intense the intervention is at sites which do not include fitness centers.